Cellulitis and Your Child
Cellulitis and Your Child
What is cellulitis?
Cellulitis is a bacterial infection of the skin and surrounding tissue. It occurs most commonly around areas of broken skin, such as wounds, bug bites, or scrapes, but it can also occur in other areas. Severe and untreated cases of cellulitis may result in septicemia (blood poisoning), but cellulitis is not contagious.
What are the symptoms of cellulitis?
Swelling of the lymph glands
Redness around the area of infection
Pus or fluid drainage from the wound
The affected area is warm to the touch
Fever (temperature over 100 degrees Fahrenheit)
What can I do for my child at home?
If your child has symptoms of cellulitis, take him or her to see the doctor for a complete diagnosis and to prevent any complications. Other things you can do include:
Giving your child all medicine as directed by the doctor
Trying to keep your child from touching the infected area
Washing your hands before and after caring for the infected area
Not squeezing or puncturing the area
Using a warm compress on the affected area
Keeping the affected limb rested
Calling your doctor if you notice increased swelling, redness, or pain
Do children need to be hospitalized for cellulitis?
Although it is easily diagnosed and usually treated with antibiotics, some children may need to be hospitalized. Your child’s doctor may do blood work to test for blood poisoning. If admitted to the hospital, your child’s treatment may include:
Fluids and antibiotics given by IV
Warm compresses applied to the affected area
Resting or raising of the area
How can I prevent my child from getting cellulitis?
Clean the wounds or sores with soap and water.
Use an antibiotic ointment and bandage to cover wounds.
Do not allow your child to rub or scratch the affected area.
Make sure your child wears protective clothing when outdoors or playing sports.
Get prompt medical attention for any deep cuts or puncture wounds.
Questions to ask your child’s doctor
For how long and at what times of the day should I give my child medication, if any?
How should I store the medication? In the refrigerator?
When will my child start to feel better?
Will I need to bring my child back for a follow-up visit?
Should I keep my child home from school or day care?
From which activities should I limit my child?
Are certain foods or liquids more helpful?
Which over-the-counter pain relievers do you recommend?
Which over-the-counter medications/preparations are NOT recommended?
Which symptoms should I report to the doctor?
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Cellulitis is an infection of the skin and underlying tissues that can affect any area of the body. Not to be confused with cellulite - the cottage-cheese-like, lumpy fat often found on the hips, thighs, and buttocks, primarily of women - cellulitis begins in an area of broken skin, like a cut or scratch, allowing bacteria to invade and spread, causing inflammation, which includes pain, swelling, warmth, and redness.
Disorders that create breaks in the skin and allow bacteria to enter, such as eczema and severe acne, will put a child at risk for cellulitis. Chickenpox and scratched insect bites are also common causes. Cellulitis may also start in areas of intact skin, especially in people who have diabetes or who are taking medicines that suppress the immune system.
Cellulitis can be caused by many different types of bacteria, but the most common are group A Streptococcus and Staphylococcus aureus. In special cases, other bacteria can cause cellulitis. Cellulitis after a cat or dog bite may be caused by Pasteurella multocida bacteria. Cellulitis due to Pseudomonas infection occurs after nail-puncture wounds through sneakers. Other types of bacteria from fish and farm animals can also cause cellulitis.
One specific type of cellulitis that can occur in children and requires close monitoring is periorbital cellulitis, an infection of the eyelid and tissues surrounding the eye. It can be the result of minor trauma to the area around the eye (such as an insect bite or a scratch), or it may be the extension of another site of infection, such as sinusitis. Periorbital cellulitis is treated with antibiotics and close follow-up. If untreated, it can progress to orbital cellulitis (infection of the eye orbit, or socket), a much more severe infection that results in a bulging eyeball, eye pain, restricted eye movements, or visual disturbances. This is an emergency that requires hospitalization and intravenous antibiotics.
Signs and Symptoms
Cellulitis begins as a small, inflamed area of pain, swelling, warmth, and redness on a child's skin. As this red area begins to spread, the child may begin to feel sick and develop a fever, sometimes with chills and sweats. Swollen lymph nodes (commonly called swollen glands) are sometimes found near the area of infected skin.
Cellulitis is not contagious.
You can prevent cellulitis by protecting your child's skin from cuts, bruises, and scrapes. This may not be easy, especially if you have an active child who loves to explore or play sports. Protective equipment worn to prevent other injuries during active play can also protect your child's skin: elbow and knee pads while skating, a bike helmet during bike riding, shin guards during soccer, long pants and long-sleeved shirts while hiking in the woods, sandals (not bare feet) on the beach, and seatbelts while riding in a motor vehicle.
If your child does get a scrape, wash the wound well with soap and water. Apply an antibiotic ointment and cover the wound with an adhesive bandage or gauze. Check with your child's doctor if your child has a large cut, deep puncture wound, or bite (animal or human).
period varies, depending on the type of bacteria causing the cellulitis. For example, cellulitis caused by Pasteurella multocida has a very short incubation period - less than 24 hours after an animal bite. But other types of bacteria may have incubation periods of several days.
Cellulitis usually resolves after a few days of antibiotic therapy. However, it's very important that the child receives the medication on schedule for as many days, usually 7 to 10, as the doctor directs.
Your child's doctor can usually make the diagnosis of cellulitis by asking a few questions and examining the area of affected skin. Sometimes, especially in younger children, the doctor may also order blood cultures - samples of your child's blood that are examined in the laboratory for growth of bacteria.
Positive blood cultures mean that bacteria from your child's skin infection have spread into the bloodstream, a condition known as bacteremia. This can potentially lead to septicemia, a generalized infection affecting many systems of the body. Bacteremia can also be a cause of cellulitis in certain cases.
If your child has severe cellulitis, your child's doctor may decide to treat him or her in the hospital using intravenous (IV) antibiotics.
Children with milder cellulitis can be treated at home with the entire course of prescribed oral antibiotics, but with follow-up from the doctor to make sure symptoms are improving. The doctor may also suggest that the affected part of the body be immobilized and elevated to reduce swelling and pain. Using pain-relievers such as acetaminophen or ibuprofen may also help reduce discomfort.
After 1 or 2 days of antibiotics at home, your child's doctor may schedule an office visit to check that the area of cellulitis has improved and that the antibiotics are working to heal the infection.
When to Call Your Child's Doctor
Call your child's doctor whenever any area of your child's skin becomes red, warm, and painful - with or without fever and chills. This is especially important if the area of skin is on your child's face, or if your child has a chronic illness (like diabetes) or a condition that suppresses the immune system.
Because cellulitis can happen very quickly after an animal bite, call your child's doctor whenever your child is bitten by an animal, especially if the puncture wound is deep. Human bites can also cause dangerous skin infections and should be seen by a doctor. If red streaks develop from the infected area or symptoms worsen despite antibiotic treatment, your child should be reexamined.
Reviewed by: Elana Pearl Ben-Joseph, MD